Provider Demographics
NPI:1194051508
Name:FLOTT, MEGAN LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYNN
Last Name:FLOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 JOE V KNOX AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117
Mailing Address - Country:US
Mailing Address - Phone:704-662-6500
Mailing Address - Fax:
Practice Address - Street 1:206 JOE V KNOX AVE
Practice Address - Street 2:SUITE F
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-2811
Practice Address - Country:US
Practice Address - Phone:704-662-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
PAMA054197363AM0700X
NC0010-02549363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant